Current Prevalence of Dental Fluorosis:

Before the widespread use of fluorides in dentistry, dental fluorosis was a rarity. Today it is rampant. In the 1950s, fluoridation advocates estimated that 10% of children would develop fluorosis in fluoridated areas. Recent research, however, has found that fluorosis rates in fluoridated areas now range as high as 70 to 80%. Not only has the prevalence of fluorosis increased, but its severity has increased as well. Thus, whereas children did not develop moderate or severe fluorosis in fluoridated areas back in the 1930s, the latest national survey from the Centers for Disease Control (CDC) found that over 3% of adolescents now have this condition. Read more.

Racial Disparities in Fluorosis Rates:

In 2005, the CDC reported that the rate of dental fluorosis among black children in the United States is significantly higher than the rate among white children. As the CDC also noted, this was not the first time that black children were found to suffer higher rates of dental fluorosis. Indeed, at least five previous studies — dating as far back as the 1960s — have found black children in the United States are disproportionately impacted by dental fluorosis. Read more.

Perceptions & Psychological Impact of Dental Fluorosis:

Studies have repeatedly found that the general public perceives the tooth discoloration caused by dental fluorosis as unattractive, likely to cause embarrassment, and sufficiently displeasing to justify cosmetic treatment. In its severe forms, dental fluorosis causes highly disfiguring brown and black stains which can cause significant teasing from peers due to the “dirty” or “rotten” appearance of the teeth. Due to the central importance of physical appearance to a young person’s self-esteem, the disfiguring stains of severe fluorosis carry significant psychological consequences. Even “mild” forms of fluorosis — marked by cloudy specks, splotches, and streaks on up to 50% of the tooth — have been found to cause embarrassment and increased self-consciousness in children. Read more. 

Biology of Dental Fluorosis

Dental fluorosis is a mineralization defect of the tooth enamel known as “hypo-mineralization.”  Hypo-mineralized enamel is marked by increased subsurface porosity. Despite over 50 years of research, the exact mechanism by which fluoride causes fluorosis is not yet understood. It is commonly believed, however, that fluoride causes the effect through a toxic mechanism on the cells (ameloblasts) that form the enamel. In addition to effecting the enamel, fluoride can also effect the mineralization of dentin as well.

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